American journal of obstetrics and gynecology, Mar 1, 2017
Cervical cancer is the third most common gynecologic malignancy in the United States. Approximate... more Cervical cancer is the third most common gynecologic malignancy in the United States. Approximately 1-3% of cervical cancers will be diagnosed in pregnant and peripartum women; optimal management in the setting of pregnancy is not always clear. We sought to describe the management of patients with cervical cancer diagnosed in pregnancy and compare their outcomes to nonpregnant women with similar baseline characteristics. We conducted a retrospective chart review of all patients diagnosed with cervical cancer in pregnancy and matched them 1:2 with contemporaneous nonpregnant women of the same age diagnosed with cervical cancer of the same stage. Patients were identified using International Classification of Diseases, Ninth Revision codes and the Dana-Farber/Massachusetts General Hospital Cancer Registry. Data were analyzed using Stata, Version 10.1 (College Station, TX). In all, 28 women diagnosed with cervical cancer during pregnancy were identified from 1997 through 2013. The major...
Presentation of Case A 60-year-old man was evaluated in the clinic in mid-June because of fever, ... more Presentation of Case A 60-year-old man was evaluated in the clinic in mid-June because of fever, rigors, and sweats. The patient had been well until 10 days earlier, when anorexia, a sore throat, diffuse myalgia, arthralgia, headache, malaise, and fever (temperature, up to 39.3°C) developed, with frank rigors, night sweats, and dyspnea on climbing stairs. The sore throat had largely subsided by the time of the examination. There was no cough, nausea, vomiting, diarrhea, jaundice, light stools, dysuria, or rash. His only medication was atorvastatin, and he was allergic to sulfonamides. The temperature was 38.1°C. There was no rash, conjunctival . . .
BackgroundIntimate partner violence (IPV) is well recognized as a human rights violation and a se... more BackgroundIntimate partner violence (IPV) is well recognized as a human rights violation and a serious global health issue that has affected about a third of worldwide women at any given time. It is defined as physical, sexual, or psychological harm caused by a spouse or an intimate partner. Its short and long-term detrimental effects on women’s physical, mental, sexual, and reproductive health are well-documented. However, its effect on nutritional status is not well-studied, and previous studies have led to contradictory findings. This study aimed to explore the association between intimate partner violence and undernutrition among married Nepalese women of reproductive age.MethodThe 2016 Nepal Demographic Health Survey data was used in this study. This study used a modified version of the Conflict Tactics Scale to determine women’s exposure to IPV, and anemia and low body mass index as the proxies of undernutrition. Prevalence of IPV, anemia, and underweight were calculated acros...
5604 Background: The aim of this study is to examine changes over time in survival for African-Am... more 5604 Background: The aim of this study is to examine changes over time in survival for African-American (AA) and white women diagnosed with cervical cancer (CeCa). Methods: Surveillance, Epidemiology, and End Results (SEER) Program data 9 for 1983-2007 were used for this analysis. Kaplan–Meier and Cox proportional hazards survival methods were used to assess differences in survival by race at 5-year intervals. Results: The study included 23,722 women; including 19,777 whites and 3,945 AA. AAs were older (51.4 vs. 49 years; p<0.001), had a higher rate of regional (38.3% vs. 31.7; p<0.001) and distant metastasis (10.5% vs. 8.5; p<0.001). AAs received less frequently cancer-directed surgery (53.1% vs. 65.7%; p<0.001), and more frequently radiotherapy (56.9% vs. 47.3%; p<0.001). AAs had a hazard ratio (HR) of 1.40 (95% CI, 1.31-1.49) of CeCa mortality compared to whites. Adjusting for SEER registry, marital status, stage, age, surgery, radiotherapy, grade and histology, A...
Biotargets of Cancer in Current Clinical Practice, 2012
Endometrial cancer is the most common gynecologic malignancy in the USA and is becoming increasin... more Endometrial cancer is the most common gynecologic malignancy in the USA and is becoming increasingly more prevalent in industrialized countries. Endometrial cancer accounts for over 43,000 new cases (6% of all cancer cases) and almost 8,000 deaths annually (3% of cancer deaths). This chapter reviews current knowledge about endometrial cancer and its implication for strategies at prevention and treatment, with a particular focus on molecular mechanisms of pathogenesis and targeted therapies.
Objective. To determine the frequency of high risk (HR) HPV and intraepithelial neoplasia followi... more Objective. To determine the frequency of high risk (HR) HPV and intraepithelial neoplasia following ASCUS pap cytology screens in menopausal women. Study Design. Following IRB approval, we performed a retrospective review of all cases of ASCUS pap tests, HPV results, and relevant clinical-pathologic data in women age 50 or over from November 2005 to January 2007 within a tertiary care center. Statistical analyses were performed in EXCEL. Results. 344 patients were analyzed for a total of 367 screening pap tests. 25.29% (87/344) patients were HR HPV positive, with greater percentages of HR HPV cases occurring in women age 65– 74. Within HR HPV cases, 79.3% (69/87) underwent colposcopy. 27.5% (19/69) biopsy proven lesions were discovered, including cervical, vulvar or vaginal (intraepithelial neoplasia). Within the negative HR HPV group 3.1% (8/257) patients were diagnosed with dysplasia or carcinoma. Within both HR HPV positive and negative groups, patients with no prior history of l...
In Bangladesh, a South Asian country of 162 million people, M enopause, the cessation of menses a... more In Bangladesh, a South Asian country of 162 million people, M enopause, the cessation of menses and ovarian function, is a physiologic, endocrinologic, and normal consequence of aging. Yet, as with all female reproductive functions, menopause is also seen and interpreted socio-culturally by the values placed by a particular society on a woman’s status and worth based on her reproductive potential. The experience and interpretation of menopause is nuanced internally by each woman who goes through this transition and externally by the perceptions of her family and community. The interpretations of these experiences vary cross-culturally from a normal biological process, to transformative liberation from menses, to a state of identity loss and shame. In this issue of Menopause, Harun et al summarize the experience of menopause in a cohort of urban and rural women in Bangladesh. To understand the knowledge and attitudes of menopausal Bangladeshi women, they performed a 28-question interview of 160 women. They conclude that although women in Bangladesh had little understanding of the process of menopause, increased knowledge was associated with education, profession, and urban dwelling. They also identify shame and stigma associated with menopause in Bangladesh. In particular, a substantial proportion of both rural and urban women felt humiliated and 61% and 39%, respectively, of rural and urban women did not consider themselves ‘‘real women’’ once they lost their reproductive capacity. Additionally, 91% of women reported a deterioration of their relationships with their husbands. Their study brings up many interesting questions. Why is there stigma to menopause in Bangladesh? Is this a universal phenomenon faced by aging women in all countries? Or does Bangladeshi society, specifically, have a negative outlook on the condition of menopause?
To compare 3-year survival, length of hospitalization, perioperative mortality, risk of readmissi... more To compare 3-year survival, length of hospitalization, perioperative mortality, risk of readmission, and residual disease associated with laparoscopic and laparotomic interval debulking surgery among women with epithelial ovarian cancer. We used the National Cancer Database to identify a cohort of patients diagnosed with stage IIIC and IV epithelial ovarian cancer between 2010 and 2012 who underwent neoadjuvant chemotherapy and interval debulking surgery. We compared 3-year overall survival, duration of postoperative hospitalization, 90-day postoperative mortality, and residual disease status between women who underwent interval debulking by laparoscopy and by laparotomy. We used the Kaplan-Meier method and Cox regression models in survival analyses. At a significance of .05, this study had 80% power to detect an 8% difference in 3-year survival. The main analysis was intention to treat. We identified 3,071 women meeting inclusion criteria, of whom 450 (15%) underwent surgery initia...
American journal of clinical oncology, Oct 1, 2016
The objective of this study is to review existing data regarding the feasibility, diagnostic perf... more The objective of this study is to review existing data regarding the feasibility, diagnostic performance, and oncologic outcomes of sentinel lymph node biopsy (SLNB) versus lymphadenectomy (LND) in endometrial cancer. A PubMed search identified studies on different staging strategies in endometrial cancer, including routine LND, predictive models of selective nodal dissection, and SLNB. There is ongoing controversy over the risk-benefit ratio of LND in assessing nodal involvement in presumed early-stage endometrial cancer. Current experience with sentinel node biopsy suggests high detection rates and low false-negative rates across most series, as well as the increased detection of occult metastatic disease overlooked by conventional pathology. Although data on the long-term oncologic outcomes of sentinel node biopsy in this setting are limited, short-term follow-up shows no immediate impairment of disease-free survival or overall survival rates when compared with LND. SLNB holds pr...
American journal of obstetrics and gynecology, Mar 1, 2017
Cervical cancer is the third most common gynecologic malignancy in the United States. Approximate... more Cervical cancer is the third most common gynecologic malignancy in the United States. Approximately 1-3% of cervical cancers will be diagnosed in pregnant and peripartum women; optimal management in the setting of pregnancy is not always clear. We sought to describe the management of patients with cervical cancer diagnosed in pregnancy and compare their outcomes to nonpregnant women with similar baseline characteristics. We conducted a retrospective chart review of all patients diagnosed with cervical cancer in pregnancy and matched them 1:2 with contemporaneous nonpregnant women of the same age diagnosed with cervical cancer of the same stage. Patients were identified using International Classification of Diseases, Ninth Revision codes and the Dana-Farber/Massachusetts General Hospital Cancer Registry. Data were analyzed using Stata, Version 10.1 (College Station, TX). In all, 28 women diagnosed with cervical cancer during pregnancy were identified from 1997 through 2013. The major...
Presentation of Case A 60-year-old man was evaluated in the clinic in mid-June because of fever, ... more Presentation of Case A 60-year-old man was evaluated in the clinic in mid-June because of fever, rigors, and sweats. The patient had been well until 10 days earlier, when anorexia, a sore throat, diffuse myalgia, arthralgia, headache, malaise, and fever (temperature, up to 39.3°C) developed, with frank rigors, night sweats, and dyspnea on climbing stairs. The sore throat had largely subsided by the time of the examination. There was no cough, nausea, vomiting, diarrhea, jaundice, light stools, dysuria, or rash. His only medication was atorvastatin, and he was allergic to sulfonamides. The temperature was 38.1°C. There was no rash, conjunctival . . .
BackgroundIntimate partner violence (IPV) is well recognized as a human rights violation and a se... more BackgroundIntimate partner violence (IPV) is well recognized as a human rights violation and a serious global health issue that has affected about a third of worldwide women at any given time. It is defined as physical, sexual, or psychological harm caused by a spouse or an intimate partner. Its short and long-term detrimental effects on women’s physical, mental, sexual, and reproductive health are well-documented. However, its effect on nutritional status is not well-studied, and previous studies have led to contradictory findings. This study aimed to explore the association between intimate partner violence and undernutrition among married Nepalese women of reproductive age.MethodThe 2016 Nepal Demographic Health Survey data was used in this study. This study used a modified version of the Conflict Tactics Scale to determine women’s exposure to IPV, and anemia and low body mass index as the proxies of undernutrition. Prevalence of IPV, anemia, and underweight were calculated acros...
5604 Background: The aim of this study is to examine changes over time in survival for African-Am... more 5604 Background: The aim of this study is to examine changes over time in survival for African-American (AA) and white women diagnosed with cervical cancer (CeCa). Methods: Surveillance, Epidemiology, and End Results (SEER) Program data 9 for 1983-2007 were used for this analysis. Kaplan–Meier and Cox proportional hazards survival methods were used to assess differences in survival by race at 5-year intervals. Results: The study included 23,722 women; including 19,777 whites and 3,945 AA. AAs were older (51.4 vs. 49 years; p<0.001), had a higher rate of regional (38.3% vs. 31.7; p<0.001) and distant metastasis (10.5% vs. 8.5; p<0.001). AAs received less frequently cancer-directed surgery (53.1% vs. 65.7%; p<0.001), and more frequently radiotherapy (56.9% vs. 47.3%; p<0.001). AAs had a hazard ratio (HR) of 1.40 (95% CI, 1.31-1.49) of CeCa mortality compared to whites. Adjusting for SEER registry, marital status, stage, age, surgery, radiotherapy, grade and histology, A...
Biotargets of Cancer in Current Clinical Practice, 2012
Endometrial cancer is the most common gynecologic malignancy in the USA and is becoming increasin... more Endometrial cancer is the most common gynecologic malignancy in the USA and is becoming increasingly more prevalent in industrialized countries. Endometrial cancer accounts for over 43,000 new cases (6% of all cancer cases) and almost 8,000 deaths annually (3% of cancer deaths). This chapter reviews current knowledge about endometrial cancer and its implication for strategies at prevention and treatment, with a particular focus on molecular mechanisms of pathogenesis and targeted therapies.
Objective. To determine the frequency of high risk (HR) HPV and intraepithelial neoplasia followi... more Objective. To determine the frequency of high risk (HR) HPV and intraepithelial neoplasia following ASCUS pap cytology screens in menopausal women. Study Design. Following IRB approval, we performed a retrospective review of all cases of ASCUS pap tests, HPV results, and relevant clinical-pathologic data in women age 50 or over from November 2005 to January 2007 within a tertiary care center. Statistical analyses were performed in EXCEL. Results. 344 patients were analyzed for a total of 367 screening pap tests. 25.29% (87/344) patients were HR HPV positive, with greater percentages of HR HPV cases occurring in women age 65– 74. Within HR HPV cases, 79.3% (69/87) underwent colposcopy. 27.5% (19/69) biopsy proven lesions were discovered, including cervical, vulvar or vaginal (intraepithelial neoplasia). Within the negative HR HPV group 3.1% (8/257) patients were diagnosed with dysplasia or carcinoma. Within both HR HPV positive and negative groups, patients with no prior history of l...
In Bangladesh, a South Asian country of 162 million people, M enopause, the cessation of menses a... more In Bangladesh, a South Asian country of 162 million people, M enopause, the cessation of menses and ovarian function, is a physiologic, endocrinologic, and normal consequence of aging. Yet, as with all female reproductive functions, menopause is also seen and interpreted socio-culturally by the values placed by a particular society on a woman’s status and worth based on her reproductive potential. The experience and interpretation of menopause is nuanced internally by each woman who goes through this transition and externally by the perceptions of her family and community. The interpretations of these experiences vary cross-culturally from a normal biological process, to transformative liberation from menses, to a state of identity loss and shame. In this issue of Menopause, Harun et al summarize the experience of menopause in a cohort of urban and rural women in Bangladesh. To understand the knowledge and attitudes of menopausal Bangladeshi women, they performed a 28-question interview of 160 women. They conclude that although women in Bangladesh had little understanding of the process of menopause, increased knowledge was associated with education, profession, and urban dwelling. They also identify shame and stigma associated with menopause in Bangladesh. In particular, a substantial proportion of both rural and urban women felt humiliated and 61% and 39%, respectively, of rural and urban women did not consider themselves ‘‘real women’’ once they lost their reproductive capacity. Additionally, 91% of women reported a deterioration of their relationships with their husbands. Their study brings up many interesting questions. Why is there stigma to menopause in Bangladesh? Is this a universal phenomenon faced by aging women in all countries? Or does Bangladeshi society, specifically, have a negative outlook on the condition of menopause?
To compare 3-year survival, length of hospitalization, perioperative mortality, risk of readmissi... more To compare 3-year survival, length of hospitalization, perioperative mortality, risk of readmission, and residual disease associated with laparoscopic and laparotomic interval debulking surgery among women with epithelial ovarian cancer. We used the National Cancer Database to identify a cohort of patients diagnosed with stage IIIC and IV epithelial ovarian cancer between 2010 and 2012 who underwent neoadjuvant chemotherapy and interval debulking surgery. We compared 3-year overall survival, duration of postoperative hospitalization, 90-day postoperative mortality, and residual disease status between women who underwent interval debulking by laparoscopy and by laparotomy. We used the Kaplan-Meier method and Cox regression models in survival analyses. At a significance of .05, this study had 80% power to detect an 8% difference in 3-year survival. The main analysis was intention to treat. We identified 3,071 women meeting inclusion criteria, of whom 450 (15%) underwent surgery initia...
American journal of clinical oncology, Oct 1, 2016
The objective of this study is to review existing data regarding the feasibility, diagnostic perf... more The objective of this study is to review existing data regarding the feasibility, diagnostic performance, and oncologic outcomes of sentinel lymph node biopsy (SLNB) versus lymphadenectomy (LND) in endometrial cancer. A PubMed search identified studies on different staging strategies in endometrial cancer, including routine LND, predictive models of selective nodal dissection, and SLNB. There is ongoing controversy over the risk-benefit ratio of LND in assessing nodal involvement in presumed early-stage endometrial cancer. Current experience with sentinel node biopsy suggests high detection rates and low false-negative rates across most series, as well as the increased detection of occult metastatic disease overlooked by conventional pathology. Although data on the long-term oncologic outcomes of sentinel node biopsy in this setting are limited, short-term follow-up shows no immediate impairment of disease-free survival or overall survival rates when compared with LND. SLNB holds pr...
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Papers by Annekathryn Goodman